Designing Customer Services that Scale

By Joe Shields, President, Health Accelerators

Hi, I’m Joe Shields from Health Accelerators. Welcome to this module on, “Designing Customer Services that Scale.” First, we’re going to talk about why we’ve moved to services. There’s a couple of reasons; one is globalization. Services are really something within the pharmaceutical industry that have enabled brands to become more relevant and frankly provide more service to their customers. Next is patient empowerment. Patients are demanding more services, particularly with the more expensive products that are out there.

Competition, how can you be flat-footed if your competition is excelling in not only the product but also the services that are wrapped around the products, beyond the pill is what we used to say. REMS, the kinds of programs that are about risk mitigation are the foundation of service frankly in terms of making sure that the drugs are used safely, patients are not harmed, and physicians are very well aware of the risks associated with those products. The unmet need – a lot of us have done research in ethnography. A lot of us have done research in patient center design, things like that. It’s really about making sure that we understand the unmet need and seeing if that unmet need has been satisfied by another competitor, by a third-party, or by let’s say a government program.

The sixth reason I think is that there are more complex medicines out there. They’ve been out there for some time. Patients need a lot more hand-holding. They need a lot more coaching. They need a lot more information, tools, and services to make sure that they’re using the product safely.

Another reason that services have exploded particularly within pharma is the internet. We celebrate the 30th anniversary of the internet this year. There’s an explosion in terms of as we said patient empowerment, but there’s been a lot of changes in terms of how patients and physicians access information about health, how they access services. The bandwidth has exceeded our expectations, so people can actually get things almost instantly. Everybody, of course, carries a smart phone.

Number Eight is rising customer expectations. There’s a concept called liquid expectations. As expectations go up, as a consumer maybe has a great experience with Amazon or Zappos or you name it, their expectations don’t go back down again just because they’re dealing with a health system. I think we also need to keep that in mind that health and pharma are not just competing in the service arena with other pharma companies, but they are competing with world-class suppliers like Amazon, like Apple who have really created very high expectations for customers.

Then finally, there’s this need to innovate. A lot of these programs even though they are patient support programs really come out of the marketing department. There’s a lot of – within a marketer’s makeup, there is a lot of desire to innovate. You see new technology. You see changing customer trends. You really do want to respond to it to make sure that your brand and your company is well positioned to serve customers but also serve the market.

That’s some of the reasons that we look at services as a differentiator for pharmaceutical products. Another reason is services really can help solve customer problems. If we think about the old days which were not too long ago, most of what we relied on were fairly static brochures, or simple websites, articles, slides, and even some simple apps. Those days are over. Let’s be honest. I think what we’re finding is that the kind of research that we’re doing, ethnography, user center design, and those kinds of things that you see on the right side of the screen, it’s been an explosion thanks to the consultancies, thanks to the design shops, and also the agencies within healthcare that they’ve really created this ecosystem that’s gotten much deeper insights and really has uncovered a different kind of need let’s say then if you just did concept research on a print ad or something like that.

Scale is important for a lot of reasons. One is you’re going to invest the same amount of effort or very close to it to serve a few people, let’s say in rare disease, or serve a lot of people, let’s say in diabetes. Now, I’m not saying one’s better than the other, but if I’m working 8, 10 hours a day, whatever it is, and I’m working on something that I know is going to be important to patients, I absolutely want it to reach as many patients, or frankly, as many physicians as possible. What I try to do is understand that I need to build scale in from the beginning.

The great thing about scale too is you can gather insights more quickly; you have volume. It’s not just an N of one or an N of 10, but you actually have some valid research statistics. We see that a lot from patient communities that are quite large. You can amortize this functionality and the development costs across a larger base. Frankly, you can reuse content and functionality. If you start to scale let’s say from diabetes to hypertension, you’re able to transfer a lot of the things that you built like let’s say a registration form instead of rebuilding it again.

Pharma’s not really designed for being in the service business for the most part. It’s optimized really to discover, manufacture, market, and sell medicines. Digital health is not really a mature business development function in many pharma companies. Where there is quite a lot of effort, and staff, and expertise applied to finding new molecules, finding new medicines, finding new partners, but you don’t see that a lot on the digital health side. I think you see it in dribs and drabs and you see it in pieces, or maybe there’s one expert in a company. I think that’s going to evolve very quickly over time is that you will start to see a partnership mentality within pharma and within med device companies to really partner with a lot of these digital health startups.

Then finally, there’s some physical restrictions. If even though it’s digital if you have a connected device like a smart inhaler, or a connected insulin pump, or glucose meter, there are physical things. There are pieces of plastic and pieces of engineering that need to be designed, manufactured, and shipped. Frankly, if you want to reach a million patients with an inhaler that’s connected, that’s a million times that unit. If that unit costs $4, that’s another $4 million dollars you need to add on top of your program. There are some limitations I’d say when the digital crosses over into the physical world.

You can see pharma’s not really designed to be in the service business for the most part. Speaking of design, let’s have a look at an example here. On the left is a perfectly good light bulb. This is what the customer asked for. We know they asked for this or maybe they didn’t explicitly ask for this, but we learned through ethnographic research, and social listening, and other techniques that this is what they actually really need, and this is what they want.

If you look on the right, this, unfortunately, is many times what pharma builds for them. It’s not ill-intentioned; I think it’s really just a question of the resources weren’t there, or there were internal struggles, or there was maybe silos that aren’t connected, or frankly, there was some regulations that said look, the patient wants this, or this physician wants this; we just frankly can’t do it because of the regulations. That’s somebody else’s job. I think that’s part of that legacy within pharma is also as rewarding marketing creative or advertising creative even though these programs are much different and should be judged differently.

Let’s have a look at a simple process. Once again, many agencies, many pharma companies, many suppliers use these processes to create things and this is no different. This is not rocket science. We’re going to have a look at it in terms of, how do you create scale, but you do it from the start so that you’re building a pilot knowing that it has the potential maybe to globally scale across let’s say 100 countries in 10 therapeutic categories.

First, are we solving the right problem? We need to define an important problem worth solving for the customer. I think we’ve all seen solutions, maybe even coming out of Silicon Valley that solve lots of problems for a very small number of rich people. I think in healthcare, we’re really trying to not do that. We’re really trying to find the problem that is worth solving for lots of people.

I think in that pursuit, we create a problem hypothesis. Once again, this is like the scientific method. In this particular case, “We believe that many people with this condition are fearful about self-administration at home, because….” fill in the blank. The hypothesis step makes sure that we’re solving the right problem.

The second step is really an insights phase where you’re validating the problem, making sure that the problem is real, it hasn’t already been solved by somebody else, so you do some landscaping, that it’s widespread, it’s important, it’s valuable to solve. Sometimes we say what’s the size of the prize. Then it’s somewhat universal and not overly market specific.

For instance, it’s not just for Japan, or it’s not just for Argentina, but it has some universal appeal particularly if it’s for patients. Then finally, is it measurable? Is there a way that we’re going to know that we’ve been successful where we’ve actually solved the problem when all is said and done?

The third step is design, which is really about creating a clear design target. First of all, we need to clearly articulate the problem to be solved. Based on Steps One and Two, it really is understanding what the problem is and is it worth solving. Then this step is really about what is the design target. Often in pharma, we use what we call a TPP in drug development which is a target product profile. In many ways, this could be a good analogy for the design target in a service model.

What we need to do is also balance the need for a consistent global solution with needs of whether it’s specific conditions, or specific patient types, or specific countries if you’re thinking globally. There’s a balance between that global platform and then customization at the local level. Then finally, there’s something called a user requirement specification or URS. That is very similar as we said to a target product profile. This is once again clearly defining what it is you’re trying to sell for.

Step Three is all about design and Step Four is all about development. When we talk about development, it really is how do we make this ready for scale. Obviously, we want to go out, and we want to pilot it, and we want to test it, but sooner or later if it works, we may want to go bigger. What we want to do is plan for that from the beginning because many times you see pilots that are designed to be pilots and they frankly can’t scale whether it’s a software reason, or resources, or frankly, somebody just didn’t think it through at the beginning.

This is really about modularization and standardization. Once again, if you’re inside of a pharma company building on your standard company platform which unfortunately may be a little bit limiting. You won’t’ feel that innovative, but at the same time, if you need to scale globally, you’ll be able to do that more easily if you are working on company platforms and if you bring in some proprietary platform, or software, or vendor that’s non-standard. You think about modularity. You also think about reusability. Once again, the example we had earlier is if you are designing a program where there’s a registration module, you can certainly use that over and over again no matter what kind of customer, what kind of condition, what kind of country they’re in. Obviously, there’s some rules there.

You also need to manage your stakeholders throughout the process. Development is about building. It’s about also engaging and enrolling your stakeholders. Those are the people funding it. They’re the people that will need to roll it out, train it, and support it over time. You want to make them maybe not your best friends, but at least you want to bring them into the tent with you to help co-create this experience.

Then finally, you need a plan. A lot of times it’s called a roadmap. That’s a fairly common term that IT uses in terms of what is the path ahead? Where are the feature enhancements coming from? Where are the software updates? This is a way to keep people on track because as the program rolls out, you’ll get lots of requests for one-offs here and there.

You’ll get lots of ideas for new functionality which you can certainly fold into the plan, but I think what you don’t want to do is just react to every request that you get. It will slow you down. It’s very expensive. It makes it difficult to scale something like that.

Step Four is all about development and Step Five is that next stage which is about delivery. How do we actually introduce this into the real world? On the slide there, you see that we’re planning for reality. Reality is people carry different size devices. People don’t have the most up to date software.

There are regulations. There are other confounding things within the healthcare system both nationally and locally. I think as we create systems or as we create programs, support systems for patients, we need to understand that they’re operating not in a vacuum but certainly in a world that has limitations and other competing interests.

It also I think begs the questions about really what do you go out with in that first iteration? What we call the minimal viable product, or MVP, is really a good place to start once again I think as pharma gets more in-depth into experience design and support services really thinking more like a software company like more Microsoft. How do they actually create and manage software and sustain it over time? You need to refine the roadmap. It’s a living document.

You need to define the criteria of how you’re going to gather and process customer feedback and actually change the roadmap. Because every change that you make on that will be an expense, it will be some change management, and it will certainly impact the overall design of the product and the experience that somebody’s going to have. It’s very important to manage that process.

Different markets will likely use different elements. As we spoke about earlier, not everybody can afford the US version of a patient support program, so you may need to think more modularly. Also, think about the minimum viable product may only be two or three things let’s say in Canada whereas in the US, maybe they can afford eight things that work together seamlessly.

Distribution, how do you get it out to your customers? I think it really is thinking differently about this than a drug launch and drug promotion. If you’re marketing and you’re transitioning over to service design, it really is about thinking about this as a capability, not as a campaign.

You need to create a playbook for these markets, or for the brands, or for your internal customers. You need to show them what the recipe is. How do you put these components together? What have you learned? What have you learned from other experience that you’ve tried in pilots or maybe from the markets that have tried this first?

I think it’s important also to support the first few launches once again whether it’s in the US with the brand or whether it’s globally within a market. You show them some extra love and attention to make sure that it succeeds. That means if you get on a plane and go supervise or if you help line up local vendors to make sure that it’s going to succeed, that’s what you do because I think it’s important for leadership in a company to understand this can be managed and this can work given the right support.

Be realistic about what it’s going to take from a global standpoint, from a local standpoint, not just for this year, not just for next year, but really how do you sustain that for the next 5 years or 10 years? These six steps make up a process that’s very logical, very methodical, and once again will set you up for success from the kernel of an idea to global scale. I think the feedback is essential in terms of informing, providing insights, but also really helping you shape the roadmap for the future.

Finally, sustaining a successful system will take more than money. If we think about change management, there’s usually people, process, technology, and governance. There’s no difference here. We think about people. We want to make sure that you’re hiring the right people, the right skills, and the right reward systems, and the right training to make sure that these people are service-minded, and they’re not maybe pulled out of manufacturing or pulled out of normal marketing roles to figure this out.

Second is the technology which is really about making sure that you have world-class technology that’s also scalable and responds to customer requests for change. The third is about process and really understanding that certain pharmaceutical company processes, certain agency processes will need to change. If you’re managing primarily a software product, it’s much different than marketing a drug.

Then finally, there’s governance: understanding who’s paying for things, who has decision power, and who really is charting the course for this, and what value it’s adding to the company. I’d add measurement in there as well to really make sure that you understand what you’re getting for your investment. Once again, it may not be all about refills; it may not be all about selling more pills. There are other ways to measure the value of these types of programs.

The very last points I’ll leave you with are services really can help you differentiate your products if done correctly. They’re really a way to carve out a niche that maybe your competitors can’t catch up to. Number Two, services can really help a lot of patients and a lot of physicians to provide better care. Number Three, you really do need a systematic approach.

You can’t just wing it. You can’t just say, well, the pilot will automatically turn it into something big. You need to plan for that. The previous slides that you saw will maybe give you some ideas on how to do that. Thanks for watching. Hope you enjoy this module.

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